On November 6, 2012, the voters of Massachusetts rejected, by 51%, a ballot question that would have legalized physician-prescribed suicide. Question 2 was vigorously opposed by the Catholic Church and others who believe that suicide is never the answer. Groups representing the medical profession and advocates for the disabled also opposed.

Question 2 illustrated a couple of the reasons why enacting law by popular initiative is inferior, as a process, to enacting bills in the legislature.

The choices on a public policy question may be properly framed as "no" and "yes, under such-and-such terms." Say a bill is filed in the legislature to legalize physician-prescribed suicide. Some legislators will be opposed. Others may be open to the idea; for them the job is to work out under what circumstances, and subject to what restraints, it will be legal. Through this process the legislature decides both what is to be done and the manner in which it will be done. When a bill is introduced in the legislature amendments may be offered; some may be accepted. Bills approved by the legislature have been, in many cases, improved by this system of debate and deliberation. On the other hand, a ballot question may be answered in just one of two ways, "no" or "yes." A complex policy question is reduced to a single solution, written by the proponents of the initiative, with no ability to improve it by amendments prior to passage.

That leads to the second flaw in use of the initiative to enact policy. A complex policy question is put to voters who, in most cases, will have given very little, if any, thought to it until shortly before the election. This is especially so considering that ballot questions generate much less press and public interest than "top of the ticket" races for President and Senator. Unlike our elected representatives who vote on a bill after hearings, debate, and deliberation, voters deciding a ballot question will, in many cases, be informed, if at all, by "sound bite" advertisements on radio and television.

Polls several weeks out from the election showed the public quite favorable to Question 2. Opponents of physician-prescribed suicide could not reasonably expect, in the brief window of public interest, to persuade voters that not only religious teaching, but also reason and natural law, dictate that physicians should not be angels of death. Therefore the opponents, wisely, crafted their public campaign around what they characterized as flaws in the proposal. This had the advantage of persuading some voters, who might not oppose physician-assisted suicide in all cases, to oppose this particular proposal. However, that left the underlying question not only unanswered, but un-debated. Physician-prescribed suicide is, literally, a question of life and death. Such questions require sober reflection, sound education, and serious evaluation. A simple "yes" or "no" ballot question with most of the discussion consisting of little more than "sound bites" is no way to deliberate over, let alone settle, such a policy issue.